Tag Archive for: second opinions

Do Black and Latinx Veterans Face Unique Lung Cancer Challenges?

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Do Black and Latinx Veterans Face Unique Lung Cancer Challenges? from Patient Empowerment Network on Vimeo.

What unique challenges do Black and Latinx veterans face in lung cancer? Expert Dr. Drew Moghanaki from UCLA Health explains the importance of trust, second opinions, and proactive advice for the best care.

[ACT]IVATION TIP

“…for anyone who might have some trust concerns. No one owns you as a provider that you have to get care from them. If you’re comfortable, you can ask for a second opinion. If not, it is absolutely okay. Patients all the time are getting second and sometimes even third opinions. And I strongly recommend getting another opinion if you’ve got any questions or doubts, because that trust alliance is so important to get the best lung cancer care…”

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Transcript:

Lisa Hatfield:

Dr. Moghanaki, what specific challenges do veterans from the Black and Latinx communities face when trying to access healthcare services, and what are we learning from these challenges, and how is that information shaping care for veterans facing lung cancer?

Dr. Drew Moghanaki:

Well, this question just reminds me that healthcare is complicated, especially lung cancer care. And the most important thing for anybody getting care, regardless of what social, economic background or ethnic background they may be from, is to find a team that you trust and who you know will care about you. And that’s the best way to make sure you get the best treatment. I myself as a physician. I’ve also been a patient at times.  And if I don’t trust my care provider, I basically ask for a change. And I know that can be difficult.

And so here’s my activation tip for anyone who might have some trust concerns. No one owns you as a provider that you have to get care from them. If you’re comfortable, you can ask for a second opinion. If not, it is absolutely okay. Patients all the time are getting second and sometimes even third opinions. And I strongly recommend getting another opinion if you’ve got any questions or doubt, because that trust alliance is so important to get the best lung cancer care, because it’s not going to be a one-time visit. You were talking about relationships that can last months or even years to get the best treatment for your lung cancer.

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What Are the Benefits of Myeloma Consults and Second Opinions?

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What Are the Benefits of Myeloma Consults and Second Opinions? from Patient Empowerment Network on Vimeo.

What can myeloma consults and second opinions bring to patients? Expert Dr. Ola Landgren from University of Miami Sylvester Comprehensive Cancer Center discusses the benefits of consults, second opinions, and myeloma specialist centers.

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Transcript:

Lisa Hatfield:

I’m going to segue into a comment that I always make to myeloma patients. As Dr. Landgren was explaining all of these treatment options, he is on top of all the latest and greatest news and therapies. I always recommend to myeloma patients newly diagnosed or otherwise to seek out at least one consult from a specialist. If you have difficulty accessing care, then a lot of places can do video conferencing, but even that one consult to see a myeloma specialist is so important in your care and treatment options. So I’ll just throw that out there, Dr. Landgren, as a myeloma specialist that you are, we appreciate your expertise in explaining that so well.

Dr. Ola Landgren:

I agree 100 percent with what you said, and I would like to add to that and say, going to a specialist center and it doesn’t have to be here, can really really help. It can be a lot of small things. There is data indicating that survival is longer for patients who have access to specialists. That has been published in the Journal of Clinical Oncology. The Mayo Clinic has published that, I think it was more than one year longer survival.

That by itself is, of course, very strong, but I also think that there are a lot of the small things like the different types of pre-medications, the drugs that are given around myeloma drugs. Could you decrease the dose of some of these drugs like the dexamethasone (Decadron)? Could you get rid of Benadryl if you give the antibodies? These may look as small things, but they can make a huge difference for quality of life.

We have a lot of people coming for second opinions, and we always say if you live closer to someone that you trust, you should go back and be treated there. You can always reach out to us. We are happy to be involved. You have us as a backup. We can be your quarterback if you ever need us. I think that is absolutely the best advice for every patient. Go and get feedback and if you’re not sure about the feedback you get, you could always have two different quarterbacks and you could ask them. I don’t think having 10 or 20 is going to help, but having one or two second opinions, I think is a good decision.

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Dr. Kami Maddocks: Why Is It Important for You to Empower Patients?

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Dr. Kami Maddocks: Why Is It Important for You to Empower Patients? from Patient Empowerment Network on Vimeo.

What benefits can patients and care providers see from empowering patients? Expert Dr. Kami Maddocks from The Ohio State University Comprehensive Cancer Center explains benefits that she’s seen in her patients and ways that she helps encourage deepening of their knowledge and capacity for informed treatment decisions.

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Transcript:

Dr. Kami Maddocks: 

I think empowering patients is so critical, because I think when they understand their disease better, the treatment options, or why they’re not receiving treatment and kind of what their journey could look like, that they overall do much better. I think when a patient comes in, I like to give them my explanation of their disease, make sure that I am answering all of their questions, information. Some patients have read a lot before they come in and some have not read a lot. I like to provide them with websites or areas of information that I know is accurate and up-to-date information and encourage them once they read that to give us a call.

We also provide them some written information and I have a 24-hour line. And I always encourage patients, I don’t know whether you’re getting treatment and having a side effect, whether you’re at home worrying about a symptom, whether you have a question about what’s going on, I don’t know that you’re worried unless you let me know.

So I like to encourage patients, if you have questions, concerns, please reach out. We also have a portal where patients can ask non-urgent questions if they’d rather have it in writing, but I think making sure that they know we’re here to help them. I think offering information on clinical trials, I encourage patients if they have questions or concerns on the information they’re provided that they think about second opinions.

And patients that I see for second opinions I like them to know that you’re getting great treatment locally or this treatment is something that you don’t have to drive here for if you need treatment. But I’m always available if there’s other concerns or something doesn’t seem right. So I think making sure that patients’ questions are answered. I think making sure that they are comfortable getting other opinions if they need to and making sure that they know that if they have concerns they should reach out and not worry or use Google but use us to help them.

INSIST! Gastric Cancer Resource Guide

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Gastric Cancer: How to Access the Best Care and Treatment for YOU Resource Guide

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Follicular Lymphoma Monitoring and Maintenance: An Expert Weighs In

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Follicular Lymphoma Monitoring and Maintenance: An Expert Weighs In from Patient Empowerment Network on Vimeo.

What do follicular lymphoma patients need to know about monitoring and maintenance therapy? Expert Dr. Sameh Gaballa shares research about maintenance treatment, maintenance therapy risks versus benefits, and virtual visits for consults and second opinions.

Dr. Sameh Gaballa is a hematologist/oncologist specializing in treating lymphoid malignancies from Moffitt Cancer Center. Learn more about Dr. Gaballa.

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Transcript:

Lisa Hatfield:

Can you speak to maintenance therapy and monitoring in follicular lymphoma? And what signs of infection should patients and care partners be aware of during treatment?

Dr. Sameh Gaballa:  

Yeah, so there have been randomized studies in slow-growing lymphomas that show that if you do, after you get your standard treatment for follicular lymphoma, if you do what we call a maintenance treatment, usually with rituximab, which is an immune therapy, where you do it every two to three months for about two years, we have data showing that that decreases or delays the risk of relapse. However, it doesn’t change the overall survival, meaning that it just has patients in remission longer. When their disease comes back, they just get treated again at that point, and it doesn’t really affect survival.

So it’s one of those shared decision-making with the patients. I usually go over the risks and benefits of maintenance therapy. It’s optional. It’s not a must. During COVID, we pretty much stopped all maintenance treatments, because the risks were outweighing the benefits because maintenance treatment is…will suppress the immune system more, is associated with more infections. And these infections can be anything. I mean, it could be a pneumonia, could be recurrent urinary infections. It could be any type of infection. So there’s always this risk and benefit that we have to discuss with the patient.

Lisa Hatfield:

One thing that comes up, patients, I live in a state that we don’t have a lot of specialists for my type of cancer, for myeloma. If a patient wanted to consult with you, do you see patients via Zoom? Do you do consultations or maybe, I don’t want to call it a second opinion, but a consultation virtually for patients?

Dr. Sameh Gaballa:

So COVID has changed a lot of things. And that’s one of those things that have changed the way that we work, meaning offering virtual visits. And yes, sometimes we do, someone just wants to make sure they’re on the right track. They want us to review the records, review the diagnosis. We’ll get the biopsy slides reviewed here by our pathologist. And just to go over and make sure that they’re on the right track.

So yes, we routinely do those second opinions sometimes. Obviously in-person is usually better, because then we could do our own testing, and we could also examine the patients and see how they are. But yes, a virtual option is available. There are some restrictions sometimes. We cannot now see out-of-state patients as we used to, but during COVID that was not the case. But now we would have to see patients only in our state.

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Gastric Cancer Patient Follow Up Office Visit Planner

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Should Gastric Cancer Patients Consider a Second Opinion?

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Should Gastric Cancer Patients Consider a Second Opinion? from Patient Empowerment Network on Vimeo.

What should gastric cancer patients seek a second opinion? Expert Dr. Matthew Strickland explains potential benefits of a second opinion when facing a gastric cancer diagnosis. 

Dr. Matthew Strickland is a medical oncologist at Massachusetts General Hospital. Learn more about Dr. Strickland.

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Transcript:

Katherine Banwell:

Dr. Strickland, why is it beneficial for patients to seek a second opinion at a comprehensive cancer center?  

Dr. Matthew Strickland:

I’m very glad you asked this question, because there is often a disconnect that I’ve noticed. As providers, we really love second opinions or beyond. Third opinions, you name it. The disconnect that I’m talking about is often patients are a little bit shy or perhaps sheepish in telling me or asking should I get a second opinion. From the provider perspective, treating cancer is a tough business. New data is coming out all the time.  

You never know what center might have a clinical trial option that perhaps your center might not have. I would say that 99 percent of the time everyone is on the same team and looking to find the best treatment option for the patient. Again, I really can’t even think of a negative interaction I’ve had with fellow providers at different institutions. I really believe that this is a community that wants the best for the patient. So, I highly encourage at all times a second opinion or beyond.  

What Steps Can BIPOC Lung Cancer Patients Take to Guard Against Care Disparities?

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What Steps Can BIPOC Lung Cancer Patients Take to Guard Against Care Disparities? from Patient Empowerment Network on Vimeo.

How can BIPOC lung cancer patients or other underrepresented  patients help guard against care disparities? Expert Dr. Lecia Sequist shares advice for non-small cell lung cancer (NSCLC) patients to help ensure they receive optimal treatment with the most advanced treatments available.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“You don’t have to ask permission to get a second opinion, you can just make an appointment with a different oncologist or go to an oncologist if you haven’t seen one before. Because lung cancer is changing and treatments are more successful, and we all have to do more as a community to make sure that those treatments are offered to everyone.”

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Transcript:

Lisa Hatfield:

So, Dr. Sequist, we know that there are significant disparities in the treatment and the outcomes of minority patients who have non-small cell lung cancer. How can patients avoid these discrepancies in the timeliness of their diagnosis, because that can be an important factor in their outcome?

Dr. Lecia Sequist:

Yeah. I think lung cancer has changed a lot, but in the last 10 years, and there are better treatments than there used to be, and there’s a lot more treatments than there used to be, but not all doctors are aware of these new developments. And I think some doctors still have a kind of an old-fashioned nihilistic view about lung cancer, which can be very negative, which is that lung cancer can’t be treated effectively and patients are just going to do very poorly. That’s not true anymore. It may have been true 20, 30 years ago, unfortunately. But with treatments today, lung cancer patients can live longer, be cured more often and have better quality of life than with some of the older treatments.

And I think in the ideal world, the responsibility really should be on the physicians to make sure that they’re offering those treatments to patients, but in the real world, that doesn’t always happen. And so I think something that patients can do to empower themselves is also to ask their physicians if there’s anything else that can be done or if they should see a second opinion. If you’re feeling like your doctor is not offering you really many options or is being kind of nihilistic, having a very negative picture of what might happen to you with your cancer, then I would just get a second opinion. You don’t have to ask permission to get a second opinion, you can just make an appointment with a different oncologist or go to an oncologist if you haven’t seen one before. Because lung cancer is changing and treatments are more successful, and we all have to do more as a community to make sure that those treatments are offered to everyone. But until that day comes, I think patients also need to feel empowered to ask for other treatments and other opinions. 

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Can Vaccines Play a Role in Preventing or Helping to Treat Lung Cancer?

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Can Vaccines Play a Role in Preventing or Helping to Treat Lung Cancer? from Patient Empowerment Network on Vimeo.

What’s the latest in lung cancer research and treatment updates? Expert Dr. Lecia Sequist shares information about emerging research currently under study, new treatments that have shown success, and her perspective about second opinions for patient care.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…ask your doctor if they think a second opinion could be helpful.”

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Tumor Genetics vs. Family Genetics in Lung Cancer: What is the Difference

Transcript:

Lisa Hatfield.

Dr. Sequist, fortunately, the lung cancer arsenal keeps expanding. What promising treatments do you see on the horizon or that are newly available to lung cancer patients?

Dr. Lecia Sequist:

Yeah. The field is changing so fast, it almost makes your head spin. And I think it’s wonderful that there are so many options. It’s actually been a challenge for the doctors to keep on top of the latest treatments, because they’ve been coming out so fast, especially over the last five years. 

And some of the things that I’m personally excited about in lung cancer is that there may soon be an opportunity to think about vaccines that could help prevent or could help treat lung cancers. That’s something that scientists are working on that aren’t available, but it does look like it’s realistic, that it could happen. Some of the technologies that helped develop, for example, the COVID vaccine in such a short period of time might be available to personalize treatment against an individual’s tumor. So my vaccine, if I got cancer, could be different than your vaccine if you got cancer, because they’re kind of personalized.

There’s also a new type of treatment called antibody drug conjugates, which are a smarter way of delivering chemotherapy. We’ve always just given chemotherapy to the whole body, usually through a vein, through an intravenous in the arm, and it drips in and it circulates around with the bloodstream. And the good thing about that is that it can go everywhere. So if there’s a cancer cell that’s hiding somewhere too small to be seen on the scan, the chemotherapy can get there. But it does, there’s a lot of collateral damage from toxicities from delivering chemo where there is no cancer. And with these antibody drug conjugates, the idea is that there’s an antibody in the front that’s honing into some kind of target on the cancer cell. And it still goes in through the IV, but when it reaches a cancer cell and attaches, then the backend sort of drops a bomb, which is a chemotherapy on that area.

So instead of the chemo being given to the whole body, every time the front end of this thing hits cancer cells, it engages and that triggers the backend, which is the chemotherapy kind of bomb to be dropped. So there are a lot of these types of drugs where it’s more like targeted delivery of chemo. Some of them have already been approved for cancers like breast cancer, but we don’t have an approved antibody drug conjugate in lung cancer yet. But there are a couple that are moving towards potential FDA approval. So I think given how complicated the new treatments are, my activation tip for patients would be to ask your doctor if they think a second opinion could be helpful. And I think a lot of patients feel that that might be rude or their doctor might not react in a positive way to them saying, do you think I should get a second opinion?

But as a physician, I can tell you that it’s not taken that way by most doctors. And in fact, a lot of oncologists will even suggest to their patients, you know, “Hey, this is a complicated area. I would love to get input from my colleague. I’m going to  send you to a city nearby for a second opinion.” We all rely on our colleagues a lot, and not everybody can know everything about every cancer, especially with how quickly things are changing. So second opinions are not a sign that you don’t trust your doctor or you don’t like your doctor. It’s just a sign that you really want more input. The more minds, the more brains that are thinking about your cancer, the better. And don’t be afraid to ask your doctor if they think a second opinion could be helpful for your case. 

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Why Should DLBCL Patients Feel Empowered to Speak Up?

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Why Should DLBCL Patients Feel Empowered to Speak Up? from Patient Empowerment Network on Vimeo.

Why is it vital for diffuse large B-cell lymphoma (DLBCL) patients to engage in their care? Expert Dr. Amitkumar explains the importance of speaking up and the value of considering a second opinion.

Dr. Amitkumar Mehta is Director of the Lymphoma Program and CAR T Program and Medical Director of the Clinical Trials Office at O’Neal Comprehensive Cancer Center at UAB. Learn more about Dr. Mehta.

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Transcript:

Katherine:

Why should patients feel empowered to speak up?

Dr. Mehta:

So, that is very, very important because at the end, anybody and the patient is in the center. As we talked about their preferences, shared decision-making, they need to speak up because, at the end, I need to know, we need to know as a care team their preferences, right? Who is going to be my support? Who’s going to be with me? Maybe they might have to move somewhere to get the treatment, right? Or sometimes I bring up and I have so many patients who actually brought up “Well, I have a trip planned on this date,” right, or “I have a graduation planned,” or “I have son or daughter’s wedding planned,” right?

So, they should feel empowered to speak up. Yes, they’re shocked at the first instance because of their diagnosis of cancer. But that part after sharing all the information about cancer and treatment, it eases up a little bit. Then they feel “Okay, it is not end of the road,” right? “I’m going to fight it out.” But at the same time, there are important life events planned. So, they need to speak up, not only for that but also, as we talked about, preferences, their choices about the clinical trial.

Sometimes it is okay to ask whether I can go for another opinion, especially now in many institutions there are specialists who just focus on lymphomas, right? In that case, it is okay to ask whether – anywhere else I should go for an opinion and see whether I have more options. So, patient is always in center. And I feel always comfortable when patients speak up, and I make sure that “Yes, I will make sure that whatever the preference is, I will try to meet those preferences.”

Should Advanced Non-Melanoma Skin Cancer Patients See a Specialist?

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Should Advanced Non-Melanoma Skin Cancer Patients See a Specialist? from Patient Empowerment Network on Vimeo.

Do advanced non-melanoma skin cancer patients need to see a specialist? Dr. Sunandana Chandra explains the benefits of working with a specialist, how she empowers patients, and when she recommends seeking a second opinion.

Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.

Katherine:  

Why is it important that patients speak up and have a voice in their care? 

Dr. Chandra:  

Well, I think for person to feel empowered, they have to understand their cancer, in my opinion. 

And that’s part of my responsibility is to try to share what I know about their cancer, my medical and clinical experience dealing with that type of cancer, and really, to try to empower them by giving them knowledge about their cancer, about their diagnosis, about the prognosis, about potential treatment options. And, I really think that that knowledge is really empowering for our patients and their family members, and I think with that knowledge, they can make the most informed decision, and they can help us then figure out what the best management plan for them is. You know, I try to spend a considerable amount of time with my patients and their family members and loved ones to explain all of this at the get-go so that that way, oftentimes, they can go home, they can kind of think about it, come back with more questions. 

Or, if they do some additional research on their own, hopefully some of what I’ve talked about might resonate and might even spur on more questions that usually can be very helpful for us to try to answer, helpful for the patient, I mean. 

Katherine:

Absolutely. Should patients consider seeing an advanced non-melanoma skin cancer specialist? 

Dr. Chandra:

You know, for a “routine” non-melanoma skin cancer of which the most common are basal cell carcinomas, squamous cell carcinomas, they may be tiny spots, maybe one, potentially multiple, that can just be excised and the person can be followed closely. For them, perhaps seeing someone locally, maybe very reasonable.   

But, if the patient themselves is ever worried or unsure, or they feel like they want to see a specialist, I absolutely would encourage that. In addition, for a person who has recurrent non-melanoma skin cancers, you know, multiple occurrences, maybe even more advanced than others, I think that those particular patients going to a specialist or a number of specialists may really help with the most advanced care. Maybe it’ll allow the patient and their team to be more proactive, maybe allow for other options that are maybe not standards of care, maybe novel, but promising.  

And so, I think for patients who are worried or for patients with more high-risk features, more increased number of skin cancers, perhaps more advanced skin cancers, I think having an expert or a team of experts on their team is certainly worth considering. 

Katherine:

What is your advice for patients who may feel like they’re hurting your feelings by seeking a specialist or a second opinion? Any advice for self-advocacy? 

Dr. Chandra:

Oh, gosh. I mean, I always tell our patients I strongly encourage it if they bring up especially. You know, I never want to patient of mine or their family members to look back and have any regrets. And so, from the get-go, I think that they should seek opinions. They should feel comfortable with the management that I or someone else is recommending to them.  

And, if a person asks me if it’s okay if they seek an opinion, I’m actually very encouraging of it because it doesn’t hurt my feelings. In fact, I think, again, it empowers the patient, which at the end of the day I think is most important and allows, hopefully, for them to have no regrets. And, I always tell patients more heads are better than one. So, if a colleague has another idea that perhaps I didn’t think of or vice versa, having that discussion and ultimately, that may allow for better patient care, which I think is all of our goals, which is actually our ultimate goal, I should say. 

Expert Advice for Recently Diagnosed Lung Cancer Patients

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Expert Advice for Recently Diagnosed Lung Cancer Patients from Patient Empowerment Network on Vimeo.

A lung cancer diagnosis can be overwhelming. Lung cancer specialist Dr. Estelamari Rodriguez shares key advice for recently diagnosed patients, including tips related to essential testing and preparing for appointments.

Dr. Estelamari Rodriguez is Associate Director of Community Outreach – Thoracic Oncology at the Sylvester Comprehensive Cancer Center, University of Miami Health System. Learn more about Dr. Rodriguez, here.

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Transcript:

Katherine Banwell:

What key advice do you have for recently diagnosed lung cancer patients? 

Dr. Estelamari Rodriguez:

I think that a couple of things. When it’s a diagnosis of lung cancer, it’s very overwhelming, and fortunately now there’s a lot of resources online, but at the beginning there’s a lot of information that you don’t know. So, sometimes if you go online all you do is get scared. I think that you need to answer some very specific questions from your doctor. What is your stage? And then, after your stage, my next question is; what is a molecular driver of my tumor, the sequencing of my tumor?  

In the past, we thought all the lung cancers were the same, but now we know they’re many, many different types of lung cancer. And they’re the EGFR-driven cancers, the ALK, the ROS, they’re all different, they all have different treatment options. And when you go and look online, there’s organized advocacy groups around each of these mutations, and then you can get better information, and valuable kind of insight from the information that is out there. So, I think the first thing is to before you go in the internet, talk to your doctor about your stage and require, not ask lightly.  

Require that your genetic mutation, your sequencing is done at the time of diagnosis of advanced lung cancer. Because that would really determine your treatment.  

So, I think that is very important for patients that get diagnosed. And then also, understand that there are a lot of resources out there, so that you need to ask for questions, bring someone with you. During COVID a lot of the clinics were closed, but we were able to have family members join virtually the visits, and now patients can come in with their family members. 

I find that having someone else in the room who wrote answers and wrote notes, will really help you kind of get the most out of your consultation. And also ask questions for the next time you come, or we have a portal where patients ask questions online. So, the first visit where you get the most questions answered, and sometimes it’s part B and part C. So, you have to keep until you feel satisfied that you understand the plan. We also tell patients that doctors don’t know everything, sometimes the doctor that you have is not the one that you feel you have a connection with. So, know that you have rights, and there are other doctors out there, and you can get second opinions. 

So, you are the best advocate, it’s your life, and you can rely on your doctor, and their physician extenders, physician assistants, nurses, to get as much as you can from that. But also, look outside of your institution, maybe there’s a better option for you. 

Should Prostate Cancer Patients and Families Keep Using Telemedicine?

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Should Prostate Cancer Patients and Families Keep Using Telemedicine? from Patient Empowerment Network on Vimeo.

 Prostate cancer patients can still utilize telemedicine after COVID-19 restrictions have lessened. Dr. Heather Cheng from Seattle Cancer Care Alliance shares information about situations when telemedicine visits can be helpful for patients.

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 Understanding New Targeted Therapies for Prostate Cancer

Understanding New Targeted Therapies for Prostate Cancer

 What Is the PROMISE Study for Prostate Cancer Patients?

What Is the PROMISE Study for Prostate Cancer Patients?

Transcript:

Sherea Cary:

Dr. Cheng, now that telemedicine has broader applications, should prostate cancer patients and families keep telemedicine in their toolbox post-COVID?

Dr. Heather Cheng:

Yes, I actually think it’s one of the…telemedicine, in general, is one of the silver linings of COVID, I think from a member of the medical community, we had to learn…actually, I was already doing some telemedicine, limited telemedicine before COVID hit. But I do think for patients who have access to an Internet or a smartphone and are able to do their visits, it is really decreasing the burden on them in terms of how much time they have to take off work to go to their medical appointments, I think there are times when patients still have to go into clinic, for example, to get treatment, but a lot of times, at least for prostate cancer patients, they can have their PSA that prostate-specific antigen blood test, checked in a lab close to their home, and then you know, at a time that’s convenient to them. And then I can do a telehealth with them later, so that they don’t have to take as much time off work. And so, I think in some cases it’s really, really made it easier for patients, although there are still times when we do need to see them in person, it’s just really nice to have that as an option.

So, I really do think that’s a really good thing, and I hope that the medical community and patients can continue to benefit from that. The other time when it’s helpful is for second opinions and consultation, so this is also really important for patients to know about it, is the first time they’re making a big decision about their treatment and they’re not 100 percent sure maybe they want to get us that an opinion, just to make sure that other doctors agree and that they get another chance to hear the treatment options explained in a different way. And I see a lot of patients for second opinions just to kind of get more confidence, maybe they’ll still decide to get treatment with their local oncologist, because it’s easier closer to home and less disruptive than to come to see us in Seattle. But it still gives them more confidence that they’re going down the right treatment path, so I think telemedicine also makes that a lot easier for patients as well.